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Competency-based assessment is undergoing an evolution with the popularisation of programmatic assessment. Fundamental to programmatic assessment are the attributes and buy-in of the people participating in the system. Our previous research revealed unspoken, yet influential, cultural and relationship dynamics that interact with programmatic assessment to influence success. Pulling at this thread, we conducted secondary analysis of focus groups and interviews (n = 44 supervisors) using the critical lens of Positioning Theory to explore how workplace supervisors experienced and perceived their positioning within programmatic assessment. We found that supervisors positioned themselves in two of three ways. First, supervisors universally positioned themselves as a "Teacher," describing an inherent duty to educate students. Enactment of this position was dichotomous, with some supervisors ascribing a passive and disempowered position onto students while others empowered students by cultivating an egalitarian teaching relationship. Second, two mutually exclusive positions were described--either "Gatekeeper" or "Team Member." Supervisors positioning themselves as Gatekeepers had a duty to protect the community and were vigilant to the detection of inadequate student performance. Programmatic assessment challenged this positioning by reorientating supervisor rights and duties which diminished their perceived authority and led to frustration and resistance. In contrast, "Team Members" enacted a right to make a valuable contribution to programmatic assessment and felt liberated from the burden of assessment, enabling them to assent power shifts towards students and the university. Identifying supervisor positions revealed how programmatic assessment challenged traditional structures and ideologies, impeding success, and provides insights into supporting supervisors in programmatic assessment.

Professional identity impacts the workforce at personal, interpersonal and profession levels however there is a lack of reviews of professional identity research across practising health professionals. To summarise professional identity research in the health professions literature and explore how professional identity is described a scoping review was conducted by searching Medline, Psycinfo, Embase, Scopus, CINAHL, and Business Source Complete using "professional identity" and related terms for 32 health professions. Empirical studies of professional identity in post-registration health professionals were examined with health profession, career stage, background to research, theoretical underpinnings and constructs of professional identity being extracted, charted and analysed using content analysis where relevant. From 9941 studies, 160 studies across 17 health professions were identified, with nursing and medicine most common. Twenty studies focussed on professional identity in the five years post-entry to the workforce and 56 studies did not state career stage. The most common background for the research was the impact of political, social and healthcare reforms and advances. Thirty five percent of studies (n = 57) stated the use of a theory or framework of identity, the most common being classified as social theories. Individual constructs of professional identity across the research were categorised into five themes--"The Lived Experience of Professional Identity"; "The World Around Me"; "Belonging"; "Me"; and "Learning and Qualifications." Descriptions of professional identity are broad, varied, rich and multi-layered however the literature is under theorised with current theories potentially inadequate to capture its complexity and make meaningful contributions to the allied health professions.

BackgroundMonitoring food costs informs governments of the affordability of healthy diets. Many countries have adopted a standardized healthy food basket. The Victorian Healthy Food Basket contains 44 food items necessary to meet the nutritional requirements of four different Australian family types for a fortnight. ObjectiveThe aim of this study was to describe the development of a new iPad app as core to the implementation of the Victorian Healthy Food Basket. The app significantly automates the data collection. We evaluate if the new technology enhanced the quality and efficacy of the research. MethodsTime taken for data collection and entry was recorded. Semi-structured evaluative interviews were conducted with five field workers during the pilot of the iPad app. Field workers were familiar with previous manual data collection methods. Qualitative process evaluation data was summarized against key evaluation questions. ResultsField workers reported that using the iPad for data collection resulted in increased data accuracy, time savings, and efficient data management, and was preferred over manual collection. ConclusionsPortable digital devices may be considered to improve and extend data collection in the field of food cost monitoring.

Setting priorities for higher education research is essential to maximise limited resources. Our study aimed to identify priorities for higher education research at one large research-intensive Australian university. A sequential three-phase mixed methods study was conducted. Phase 1 engaged 69 students, academics, and professional staff in an anonymous qualitative online survey to identify their perspectives on priorities. These qualitative data were analysed using thematic analysis and the findings were then converted to a quantitative online survey (phase 2) that engaged 187 students, academics, and professional staff to determine the top priorities and the reasons for their choices. Descriptive statistical analysis of phase 2 Likert scales and rank order of priorities revealed the top three priorities from 39 priorities: (1) understanding how to engage students in learning; (2) understanding how to teach creative and critical thinking skills; and (3) understanding how to promote resilience, wellbeing and student connectedness. In phase 3, five focus groups with 19 participants affirmed these ratings/rankings. Our study is the first to identify research priorities for higher education to our knowledge, and may be used to focus future higher education research strategy.

: Objective: To determine the contexts under which a fresh food market program is cost‐effective in improving dignified access to nutritious food for food‐insecure individuals. Methods: A realist economic evaluation was employed. Purported cost related theories about how the program may function, known as context‐mechanism‐outcome configurations were developed. In‐depth interviews with key stakeholders (program developers, funder, local food relief agencies, volunteers) involved in the program (n=19) as well Photovoice with focus groups with market attendees (n=8) were conducted and coded for contexts, mechanisms and outcomes. A cost‐effectiveness analysis of the program was calculated whereby the cost inputs associated with operating the program were compared to the quantity and value of produce distributed. Alternative cost scenarios were evaluated in a sensitivity analysis. The cost‐effectiveness analysis was used together with qualitative data to refine theory. Results: Food insecure individuals attending a partnership fresh food market with a small fee, experienced improved, yet infrequent access to nutritious food through community connections and support a more dignified, viable access to fresh nutritious food. Conclusions: Food relief should consider alternative models. Implications for public health: More dignified food relief programs that support local connections may be part of the solution to addressing food insecurity., Food insecurity, or the inability to afford or access regular, sufficient, safe, nutritious and culturally appropriate food in a socially acceptable way, remains a wicked problem for developed countries.[sup.1] Food [...]

Learning through work is a common feature of preparing health professionals for practice. Current understandings of work-integrated learning or a 'work-based placement', focus on students being consumers of experiences rather than providing a reciprocal benefit to the organisation in which they are placed. More nuanced understanding of the ways that students can offer value to organisations may provide new opportunities and increased capacity for workplace learning. This study drew on Social Exchange Theory to explore the perceived value and benefits of work-integrated learning experiences to the organisations in which students are placed. The focus was on population health placements undertaken by dietetics students at a large Australian university. An interpretive approach was employed with interviews with placement educators and document analysis of student-generated products from their placement. Seventeen of 20 eligible placement educators were interviewed, with interview data coded using thematic framework analysis. These data were supported with document analysis of student scientific posters completed as part of assessment to develop themes which were interpreted with social exchange theory. Three themes were identified: (1) students add to the organisation's capacity, (2) benefits outweigh time cost of planning and supervising and (3) explicitly valuing students for their contributions may build trust and further potentiate bi-directional benefits. Results suggest that student placements can add value to organisations. This reciprocity of benefits should be communicated to all stakeholders involved in the university-community collaboration, including students. Social exchange theory sensitised researchers to nuanced findings that may support the translation of these study findings to other student work-integrated learning settings.

Objective: School-based prevention interventions informed by the World Health Organization Health Promoting School (HPS) framework aim to improve the health and wellbeing of school-aged children, yet few studies describe factors influencing the successful implementation of this framework in secondary schools. This study sought to explore why and how secondary schools might implement the HPS framework and factors contributing to success. Design: Qualitative case study. Setting: A single secondary school in Victoria, Australia, purposefully selected due to local recognition of an HPS policy. Method: Data collection included semi-structured interviews, document retrieval, drawings and ethnographic observation. Data were analysed using framework analysis. Results: The school had elected to implement the policy as it aligned with its existing health and wellbeing policy framework and provided a flexible yet evidence-based framework to guide a whole-of-school approach to promoting health and wellbeing. Success was perceived to be dependent on selecting easier health priority areas to address initially, the allocation of a designated team to guide policy implementation and access to a skilled health promotion worker to assist implementation. Conclusion: Study findings highlight potential reasons why and how secondary schools might implement the HPS framework and factors contributing to success. Further research is warranted to enhance the transferability of these findings and explore the impact of the HPS framework in secondary schools.

Supervision matters: it serves educational, supportive and management functions. Despite a plethora of evidence on the effectiveness of supervision, scant evidence for the impact of supervision training exists. While three previous literature reviews have begun to examine the effectiveness of supervision training, they fail to explore the extent to which supervision training works, for whom, and why. We adopted a realist approach to answer the question: to what extent do supervision training interventions work (or not), for whom and in what circumstances, and why? We conducted a team-based realist synthesis of the supervision training literature focusing on Pawson's five stages: (1) clarifying the scope; (2) determining the search strategy; (3) study selection; (4) data extraction; and (5) data synthesis. We extracted contexts (C), mechanisms (M) and outcomes (O) and CMO configurations from 29 outputs including short (n = 19) and extended-duration (n = 10) supervision training interventions. Irrespective of duration, interventions including mixed pedagogies involving active and/or experiential learning, social learning and protected time served as mechanisms triggering multiple positive supervisor outcomes. Short-duration interventions also led to positive outcomes through mechanisms such as supervisor characteristics, whereas facilitator characteristics was a key mechanism triggering positive and negative outcomes for extended-duration interventions. Disciplinary and organisational contexts were not especially influential. While our realist synthesis builds on previous non-realist literature reviews, our findings extend previous work considerably. Our realist synthesis presents a broader array of outcomes and mechanisms than have been previously identified, and provides novel insights into the causal pathways in which short and extended-duration supervision training interventions produce their effects. Future realist evaluation should explore further any differences between short and extended-duration interventions. Educators are encouraged to prioritize mixed pedagogies, social learning and protected time to maximize the positive supervisor outcomes from training.

Background: Competency-based assessment (CBA) supports the development and attainment of skills required for the workforce. Little is known about educators' experience in developing or implementing CBA in nutrition science education or their opinions on how well it captures a student's preparedness for the workforce. The objective of this study was to explore educators' experience of CBA in nutrition education in Ireland. Method: Grounded in interpretivism, in-depth, semi-structured, audio-recorded interviews were conducted with 13 educators from five of the ten undergraduate honours degree nutrition programmes across Ireland. Interviews explored experiences of CBA and perception of students training to prepare for the workforce. A reflexive thematic analysis approach was implemented whereby the data were transcribed, inductively coded, and themes identified. Results: A clear divide was evident between participants who were confident in their understanding of CBA and those who were unsure or had no knowledge of the term. Those with a clear understanding were more involved in programme development and evaluation. Three themes were identified: 'Assessment process' including intended learning outcomes, assessment design, and grading systems, 'Student-centred approach to assessment' focusing on work-based assessment and preparation for the workforce, and 'Upskilling educators' to equip educators with the skills and knowledge for professional development and to foster student success. Conclusion: The importance of CBA as a student-centred approach, supporting them to meet standards expected to practice as a nutrition professional, was the key experience of educators. Training in CBA and inclusion of more authentic assessment may better prepare students for the workforce. [ABSTRACT FROM AUTHOR]

Aims: The aims of this study were to: (1) explore perspectives of university students' and academics' regarding disordered eating, eating disorders and body image in relation to pedagogy and curricula and (2) to evaluate a co‐designed student seminar and an academic workshop on these topics. Methods: A participatory action research approach was employed whereby an educational intervention was co‐created by academics and students. An online seminar was presented to students and a 1‐h workshop was presented to academic staff. Evaluation was conducted via a post‐seminar anonymous survey for students and a pre‐ and post‐anonymous workshop survey for academics with a mix of Likert‐scale questions and open text boxes. Qualitative data were open coded, both deductively and inductively, and quantitative data were analysed descriptively. Results: One hundred and seventeen students attended the voluntary education seminar. Six themes were identified from student qualitative data which included feeling safe, empowered, inspired, connected, emotional and reflective. Problematic aspects of pedagogy and curricula were identified by students and included: using personal data for teaching, demonising language to describe food/bodies and not always feeling safe or supported to discuss disordered eating. Twenty academics shared divergent perspectives—some reported feeling concerned and challenged by the content (exploring disordered eating with students), others noted the complexity of the area, and others reported low/moderate confidence or indifference in the space and felt this content outside of their scope as educators. Conclusion: Curricula interventions that reduce triggering and shaming and increase space and support for strengthening students' relationships with food and their bodies are valued by nutrition and dietetics students. We encourage academics to consider pedagogical approaches and expand discourse in this space. [ABSTRACT FROM AUTHOR]

Effective strategies to enhance the competence of practising health professionals are limited. Communities of Practice are proposed as strategy, yet little is known about their ability to develop cultural competency and practice. This study aimed to measure the impact of a Community of Practice on the self-assessed cultural competency and change to practice of dietitians working in Aboriginal health. A mixed-method approach including a quantitative 16-item cultural-competency self-assessment tool (completed at baseline and after 12 months of participation) together with the qualitative most significant change stories were used. Quantitative and qualitative data were compared together for congruence and difference. All participants (n = 13) completed the cultural competency-self assessment and participated in the significant change story development. They reported that through networking and joint problem solving they increased competence (13 of 16 performance indicators) and qualitative described increased self-confidence for their work in Aboriginal health through improved understanding of the factors related to the impact of history, culture and utilisation of resources on service delivery, appropriate communication strategies, effective relationships and managing conflict. These findings suggests that formalised and structured Communities of Practice may be an effective workforce development strategy to influence the practice of health professionals working in Aboriginal health.

Objectives: Food insecurity remains an issue for vulnerable populations in developed countries. The potential dietary and food security impacts of nutrition education programmes in Australia remain largely undocumented. This study investigated the impacts of an eight-session nutrition education programme delivered within community case management services for young people experiencing homelessness. Design and setting: A qualitative case study was undertaken in a community-based youth housing agency in Western Melbourne, Australia. Methods: Seven semi-structured interviews and two focus groups were conducted with a purposive sample of 10 past programme graduates and five youth service staff. Data were thematically analysed using a phenomenological lens. Results: The impacts of the programme were described by four themes: (1) the nutrition education programme created a platform for social engagement, (2) reduced reliance on emergency food relief for participants, (3) participants developed food-related knowledge and skills and (4) the programme was seen as a step towards food security for young people. These impacts were dependent on a myriad of personal and programme-related characteristics. Personal characteristics included participants' intrinsic motivating factors to change their behaviours or a pre-existing interest in nutrition. Programme characteristics included the programme's flexible structure and facilitation by caseworkers that were known to the young people. Conclusion: Study findings highlight the potential impacts of a nutrition education programme on dietary behaviours and food security status when embedded within community-based services.

Background: Communication is a core element of dietetic practice, and although communication skills are a prominent feature of dietetic curricula, research suggests a need for more consistent approaches. The evidence on how communication skills are taught and assessed in dietetics has not been synthesised leaving uncertainty about best practice. This scoping review aimed to examine and map the research literature relating to the teaching and assessment of communication skills in dietetics. Methods: The review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews. Five electronic databases, two theses databases and eight conference proceedings were systematically searched for research on how communication skills are taught and assessed in dietetics. The search had no geographical or time limits. Studies were independently screened by two authors, summarised thematically using the Kirkpatrick Model and narratively synthesised. Results: The 45 included studies were organised thematically into three categories: (i) the inclusion of communication skills education in dietetics, suggesting that dietitians have variable experiences; (ii) approaches to teaching communication skills in dietetics, characterised predominantly by a move away from didactic approaches in favour of experiential opportunities for learning such as simulation; and (iii) assessment of communication skills in dietetics, including the use of both dietetic‐specific and generic tools. Conclusions: The included studies demonstrate that although a variety of teaching strategies are used in the development of communication skills in dietetics, there is potential for more robust evaluation and more diverse approaches to support dietetic educators to prepare the dietetic workforce. Highlights: Communication skills teaching is included in dietetic education, but the studies presented in this review indicate the lack of consistent approaches.There is scope for the use of more diverse teaching and assessment strategies in dietetic education to develop the communication skills required for social media and communicating with diverse populations. [ABSTRACT FROM AUTHOR]

Background: Collective impact is gaining traction to improve population health outcomes. This study aimed to determine where and how collective impact is being used in nutrition and describe current understandings of its impacts or results on health or nutrition outcomes. Methods: A systematic scoping review was undertaken with four databases ('CINAHL Plus', 'Sociological Abstracts', 'PsychInfo', and 'OVID Medline') using the search term 'Collective Impact' from 2011 up to November 2022. All studies were screened independently by two authors. Data were extracted and synthesised narratively. Results: A total of 712 different documents were identified, with four studies included in the synthesis. Collective impact approaches focussed on breastfeeding, reducing sugar‐sweetened beverage consumption, increasing access to healthy food, and obesity. Across the four included studies, promising results in improving health and nutrition were reported. Conclusion: Evaluating and reporting on the outcomes of collective impact initiatives in nutrition using robust methods is needed. [ABSTRACT FROM AUTHOR]